Nineteen people have been charged in connection with suspected schemes to defraud Pennsylvania’s Medicaid program of more than $4 million for home health care services, federal and state authorities reported on August 4.
The defendants, which included home care firm owners, home health aides, and Medicaid recipients, were charged with health care fraud and other related charges, according to the United States Attorney’s Office for the Eastern District of Pennsylvania. Prosecutors claimed the scams involved phony billing records, overlapping shifts, providing kickbacks to clients, and bogus clock-in and clock-out entries to collect Medicaid funds.
According to the Department of Justice, some home health aides reportedly sought reimbursement for care they claimed to have provided while in jail, hospitalized, out of the country, working other jobs, or otherwise unavailable to assist patients.
Federal investigators also noted repeated patterns of “impossible work hours,” such as one case in which a home health aide reportedly claimed to provide care for more than 24 hours per day on more than 1,100 separate times. Prosecutors claim the assistant claimed for over 64,000 hours “that could not have been worked,” totaling over $1.2 million in Medicaid payments.”The great fraud against the American taxpayer takes many forms,” U.S. Attorney David Metcalf said in a statement. “It is outrageous and unacceptable that anyone could steal money by billing nonexistent home care services for caregivers who were, in fact, dead, in prison, or trafficking drugs.”
Prosecutors have prosecuted seven Philadelphia-area home health aides and Medicaid recipients.
Health aides accused of billing Medicaid while in jail, hospitalized or working other jobs
One indictment accuses Joseph Pizzo, 47, and Tiziana Taormina, 52, of conspiracy and health-care fraud. Prosecutors claimed that Taormina filed claims for home care services while Pizzo was detained and employed in construction, resulting in at least $160,000 in Medicaid payments.
In a separate indictment, Donna Romsteadt, 63; Alyssa Cuculino, 27; Louise Israel, 46; and Elexis Cuculino, 51, were charged with similar health care fraud counts. According to authorities, Alyssa Cuculino and Israel were aides, while Romsteadt and Elexis Cuculino were Medicaid recipients.
According to the indictment, Alyssa Cuculino claimed for home care services while working another job or in the hospital, while Israel reportedly made claims while in jail. Prosecutors stated that the scheme resulted in approximately $445,000 in illegal payments.
Authorities also charged Albert Coccia Jr., 56, and his son, Santino Coccia, 28, with billing Medicaid for services he claimed to have provided to his father while working as a ride-share and food-delivery driver. Prosecutors stated the alleged deception resulted in over $211,000 in claims.
Prosecutors allege overseas travel, deceased employees
In another case, prosecutors claimed that Sean Murray, 58, billed Medicaid for $400,000 in home care services that were not supplied while he was at a gym, traveling, visiting a massage parlor or selling drugs. Authorities charged him with paying payments to clients to facilitate the plot.
Prosecutors also accused Charles Bowie, 53, of billing Medicaid while traveling internationally, including trips to Saudi Arabia, Jamaica, and Colombia. Authorities claimed the conspiracy involved approximately $600,000 in Medicaid billings, the most of which were fraudulent.
Another indictment charges Benevolent Home Health LLC and its owners, Khaleelah Williams, 49, and Saleemah Davis, 29, with healthcare fraud conspiracy and wire fraud. Using the plan, the company’s owners allegedly received approximately $224,000 in Medicaid payments.
Prosecutors charged the Philadelphia-based home health care company with charging Medicaid for services allegedly provided by Williams’ husband while he was selling drugs and after he was detained on drug trafficking charges. Davis and Williams have also been accused of invoicing Medicaid for services supposedly given by a deceased home health attendant.
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